Comparison of Outcomes Between Zotarolimus- and Sirolimus-Eluting Stents in Patients With ST-Segment Elevation Acute Myocardial Infarction
- Author(s)
- Hyun Kuk Kim; Myung Ho Jeong; Young Keun Ahn; Jong Hyun Kim; Shung Chull Chae; Young Jo Kim; Seung Ho Hur; In Whan Seong; Taek Jong Hong; Dong Hoon Choi; Myeong Chan Cho; Chong Jin Kim; Ki Bae Seung; Wook Sung Chung; Yang Soo Jang; Seung Woon Rha; Jang Ho Bae; Jeong Gwan Cho; Seung Jung Park
- Keimyung Author(s)
- Hur, Seung Ho
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- American Journal of Cardiology
- Issued Date
- 2010
- Volume
- 105
- Issue
- 6
- Abstract
- Zotarolimus-eluting stents (ZESs) demonstrated greater in-segment late luminal loss and
in-segment binary restenosis rates compared to sirolimus-eluting stents (SESs) in several
studies. However, no data are available in direct comparison between the clinical outcomes of
the 2 stents in unselected patients with ST-segment elevation acute myocardial infarction
(STEMI). The aim of the present study was to compare the clinical outcomes of ZESs and SESs
in real-world patients with STEMI. A total of 873 patients with STEMI (306 patients in the
ZES group and 567 patients in the SES group) were enrolled in a nationwide prospective Korea
Acute Myocardial Infarction Registry (KAMIR) from January 2007 to January 2008. The
primary end points were major adverse cardiac events, a composite of all causes of death,
myocardial infarction, and target lesion revascularization during a 12-month clinical follow-up.
During 1 year of follow-up, the primary end points occurred in 140 patients (16.0%). The use
of glycoprotein IIb/IIIa inhibitors and the occurrence of multivessel disease were more common
in the SES group. The SES group had a significantly lower incidence of major adverse cardiac
events (hazard ratio [HR] 1.52, 95% confidence interval [CI] 1.07 to 2.16, p 0.02), target
lesion revascularization (HR 2.16, 95% CI 1.01 to 4.59, p 0.046), and target vessel revascularization
(HR 2.24, 95% CI 1.18 to 4.24, p 0.013). However, no significant differences were
found in death or myocardial infarction (HR 1.37, 95% CI 0.91 to 2.05, p 0.129). In
conclusion, SESs provided superior angiographic outcomes, translating into better clinical
outcomes and negating any change in STEMI patient safety profiles compared to
ZESs. © 2010 Elsevier Inc. All rights reserved. (Am J Cardiol 2010;105:813–818)
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